International interviewing and counseling 9th ivey chapter 07

Awareness, Knowledge, and Skills: The Emotional Basis of Counseling and Therapy slide 1 of 6 Observing the Verbal and Nonverbal Language of Emotions ▲As a first step, seek to establish a

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Intentional Interviewing and Counseling:

Facilitating Client Development in a

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Chapter 7

Reflecting Feelings:

The Heart of Empathic Understanding

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Awareness and Knowledge

▲Discover the nature and central importance of reflecting feeling and what to expect when you use this skill

▲Understand and appreciate affective empathy and its relationship to cognitive empathy and

mentalizing

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Chapter Goals and Competency Objectives (slide 2 of 2)

Skills and Action

▲ Facilitate clients’ awareness of their emotional world and its effect on their thoughts and behavior.

▲ Help clients sort out and organize their mixed feelings, thoughts, and behaviors toward themselves, significant others, or events.

▲ Clarify emotional strengths and use these to further client resilience.

▲ Center the counselor and client in fundamental emotional experience basic to resolving issues and achieving goals.

▲ Facilitate executive brain functioning through emotional regulation and affective empathy.

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Reflection of Feelings: Identify the key emotions of a

client and feed them back to clarify affective

experience With some clients, the brief

acknowledgment of feelings may be more appropriate

Affective empathy is often combined with

paraphrasing and summarizing Include a search for

positive feelings and strengths.

Anticipated Client Result: Clients will experience and understand their emotional states more fully and talk in more depth about feelings They may correct the counselor’s reflection with a more accurate descriptor

In addition, client understanding of underlying feelings leads to emotional regulation with clearer cognitive understanding and behavioral action Critical to lasting change is a more positive emotional outlook.

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Introduction: Reflection of Feeling (slide 2 of 5)

My dad drank a lot when I was growing up, but it didn’t bother me so much until now [Pause] But I was just home and it really hurts to see what Dad’s starting to do to my Mum—she’s awful quiet, you know [Looks down with brows furrowed and tense] Why she takes so much, I don’t know [Looks at you with a puzzled expression] But, like I was saying, Mum and I were sitting there one night drinking coffee, and he came in, stumbled over the doorstep, and then he got angry He started to hit my mother and I stopped him I almost hit him myself, I was so angry [Anger flashes

in his eyes.] I worry about Mum [A slight tinge of fear seems to mix with the anger in his eyes, and you notice that his body is tensing.]

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▲Paraphrasing client statements focuses on

the content and clarifies what has been

communicated

▲Reflection of feelings focuses on the

underlying emotion and helps the client make his or her emotional life more explicit and clear

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▲ In Thomas’s case, the content includes his father’s drinking history, his mother’s quietness and submission, and of course, the difficult situation when Thomas was last home.

▲ Paraphrasing will indicate to Thomas that you have heard what has been said and encourage him to move further in the discussion.

▲ Paraphrase: “Thomas, I hear you saying that your father has been drinking a long time, and your mother puts up with

a lot But now he’s started to be violent, and you’ve been tempted to hit him yourself Have I heard you right?”

▲ In this example, we are focusing on what is happening and seeking to understand the total situation

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▲The first task in eliciting and reflecting feelings is to recognize the key emotional words expressed

by the client

▲In Thomas’s case, you may have noticed “really hurts,” “angry,” and “worry.”

 You know the client has these feelings because he has made them explicit

▲Basic reflections of feelings would be “It really hurt,” “You felt angry,” and “You are worried.”

 They include the client’s exact main words.

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Awareness, Knowledge, and Skills: The Emotional Basis of Counseling and

Therapy (slide 1 of 6)

Observing the Verbal and Nonverbal Language of Emotions

▲As a first step, seek to establish and increase your vocabulary of emotions and your ability to observe and name them accurately.

▲Six primary emotions: sad, mad, glad, scared, disgust, and surprise.

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Awareness, Knowledge, and Skills: The Emotional Basis of Counseling and Therapy (slide 2 of

6)

▲ Take a moment now and develop your own list using your experience and intuition.

 Then you can compare that list with ours.

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6)

Expanding Emotional Vocabulary

▲ Sad/unhappy, mad/angry, scared/afraid are also the center of much of the work done in counseling and therapy

▲ If we are to work to improve executive functioning and cognitive competence, we must deal with these challenging emotions constantly from a base of positives and strengths

▲ Enabling some clients to recognize underlying emotional anger will be a breakthrough, allowing for cognitive change

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6)

Limbic Brain Structures Central in Affective Empathy

1. Amygdala: Emotional (and cognitive) driver, taking information from the senses and passing it on.

2. Prefrontal cortex (PFC): Labels emotions as feelings and, when possible, regulates action.

3. Hippocampus: Memory center that holds and distributes information throughout the brain.

4. Hypothalamus, pituitary, and adrenal glands: Produce the hormones for our brain and body.

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▲ The left prefrontal cortex is the primary location of positive emotional experience (e.g., glad/happy)

▲ If you use a strength-based approach based on positive psychology and therapeutic lifestyle changes, you can help clients achieve mental health and effective problem solving much more quickly

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6)

Confusion, Frustration, and Mixed Feelings

▲ Clients often express themselves in unclear ways, demonstrating mixed and conflicting emotions

▲ Help clients sort through these more complex feelings

▲ Basic emotions appear to be universal across all cultures, but the social emotions appear to be learned from one’s community, culture, family members, and peers

▲ Emotions become better defined with cognitive understanding

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The Skill Dimensions of Reflection of Feeling (slide 1 of 5)

2. Add an emotional word or feeling label to the stem

3. Add a brief paraphrase to broaden the reflection of feelings

4. Choose an appropriate tense to convey immediacy

6. Bring out positive emotional stories and strengths to counter the negatives and difficulties

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 All clients have vital emotional lives, whether they are aware of them or not.

 With children, acknowledgment of feelings may be especially helpful, particularly when they are unaware of what they are feeling

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The Nonverbal Language of Emotion: Micro and Macro Feelings

▲ Macro nonverbals are those that are relatively easy to see

▲ Micro nonverbals are fleeting expressions of concealed emotion, sometimes so fast that they happen in the blink of an eye

 Learn to observe these as they can be reliable indicators of underlying feelings as macro nonverbals

 Note them and watch for a time that these observations may be shared in the session

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Diversity and Reflection of Feelings

▲ Many of your clients of diverse backgrounds will come to you having experienced various types of discrimination and prejudice.

▲ Respect individual and cultural diversity in the way people respect feelings.

▲ Style of emotional expression will depend on individual upbringing, acculturation, and other factors.

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2 N am

e t he fe elin g

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Observe: Reflecting Feelings in Action

EXAMPLE COUNSELING SESSION: MY MOTHER HAS CANCER ; MY BROTHERS DON’T HELP

▲ Difficult life situations bring with them many emotions

▲ Whether you are dealing with clients who experience physical illness, interpersonal conflict, alcohol or drug abuse, or challenges in the work or school setting, learning the way they feel about the situation is vital

▲ The intentional interviewer or counselor is always alert to emotions underlying all situations and knows how to bring them out.

▲ Busy physicians and nurses may sometimes fail to deal with emotions in their patients, or they may have little time to help family members of those who are ill

▲ Illness can be a frightening experience Family, friends, and neighbors, as well as professionals, may have trouble dealing with it

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Multiple Applications of Reflecting Feelings (slide 1 of 6)

Helping Clients Increase or Decrease Emotional Expressiveness

▲ Observe nonverbals.

▲ Pace the conversation and encourage clients to express more emotion.

▲ When tears, rage, despair, joy, or exhilaration occur, help the client reorient to the present before reflecting and

discussing feelings.

▲ Reorient the session toward emotional regulation.

▲ When working with emotion, use caution, as there is the possibility of reawakening issues in a client who has a history of

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▲Positive emotions color the ways people respond to others and their environments

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▲“Sad, mad, glad, scared” is one way to organize the language of emotion

▲We need to give more attention to glad words such as pleased, happy, contented, together,

excited, and delighted.

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▲Take a moment now and think of specific situations when you experienced each of the positive emotions listed in the previous sentence

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Depression, Emotion, and the Body

▲Executive functioning and emotional regulation break down in the absence of positive feelings and emotions.

▲Working with depression can be challenging, but our goal is to increase positive functioning.

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Multiple Applications of Reflecting Feelings (slide 6 of 6)

▲Reflection is a basic skill of the interviewing, counseling, and therapy process, yet it can be overdone

▲Often a short and accurate reflection may be the most helpful

▲Briefly identifying unspoken feelings can be helpful too

▲However, not all clients will appreciate or welcome your comments on their feelings

▲Brief acknowledgment of feelings may be received with appreciation early on and can lead to deeper exploration in later sessions

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Action: Key Points and Practice

▲Identifying Emotions and Naming Feelings

▲ Expanding the Emotional Vocabulary

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